This study assessed the quality of the Aboabo River and examined the anthropogenic factors that lead to river pollution. Physico-chemical and bacteriological assessment of water samples showed that water from the Aboabo river was polluted and therefore not suitable for domestic consumption. Observation, in-depth interviews, informal conversation and a cross-sectional survey of 396 households in the river basin were employed to elicit qualitative and quantitative data. Direct anthropogenic factors identified were indiscriminate dumping of refuse, channelling of raw sewage, open defecation and indiscriminate dumping of industrial waste into the Aboabo River. Remote factors identified were population growth and institutional challenges. Recommendations made include enforcement of by-laws, provision of adequate sanitation facilities and the encouragement of opinion leaders to play an active role in promoting the inculcation of environmentally friendly practices amongst residents.